CHICAGO — A father lost his job at a medical device company that is facing a new tax. A young woman got back on her parents’ insurance and was able to get surgery for an injury that could have hobbled her. A part-time sales woman stopped putting off a colonoscopy and cancer screenings and saved nearly $3,000 because health plans now must pay for preventive care without co-pays. A business owner received a tax rebate for providing health coverage to her employees.
As the U.S. Supreme Court prepares to hear arguments on President Barack Obama’s health care overhaul, The Associated Press spoke with a variety of people to hear their experiences so far with the landmark legislation, whose major provisions don’t take effect until 2014. Reporters asked: How has the health care law affected your life?
Here are snapshots of seven Americans:
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Name: Michael Esch
Home: Warwick, N.Y.
Age: 48
Occupation: Former middle manager for medical device company, now working as a hospital purchasing agent.
Insurance coverage: Paying out of his own pocket for COBRA insurance through his former company.
Esch, a father of three, lost his job in November in a layoff his employer said resulted from President Barack Obama’s health care law. Medical device maker Stryker Corp. announced in November it intended to lay off 1,000 workers worldwide to save money ahead of a 2.3 percent tax on medical devices that starts in 2013.
The tax on medical devices is meant to help pay for expanding health coverage to uninsured Americans. The Obama administration argues device companies will gain in the long run as more patients become eligible to receive their products because they have insurance.
Esch was a middle manager who had worked for Stryker for six years. He helped develop a product known as the Triathlon Knee. Since the layoff, he’s taken a salary cut to work as a hospital purchasing agent. He’s still looking for a job with another medical device company.
He blames the medical device tax for the loss of his job, but he’s grateful for the provision in the health care law that will allow his oldest child, now a college sophomore, to stay on his health insurance to age 26.
“We tend to forget that for every great idea there is a ripple effect through other sectors of a business,” Esch said.
Economists say most companies should be able to pass on the bulk of the tax to customers, but the industry says it will squeeze profits and chill investment, hiring and innovation.
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Name: Glenn Nishimura
Home: Little Rock, Ark.
Age: 62
Occupation: Consultant to nonprofit groups.
Insurance coverage: Uninsured since COBRA coverage from a previous job expired in May of 2009.
Nishimura has been uninsured for nearly three years. He lost his health coverage after he left a full-time position with benefits in 2007, thinking he could land another good job. The recession destroyed that plan.
He’s been denied coverage because of high blood pressure and high blood-sugar levels. A provision in the national health care law gave his state $46 million to insure people like him who’ve been denied coverage because of pre-existing conditions.
But Nishimura said he can’t afford the coverage. It would cost him about $6,300 a year in premiums with a $1,000 deductible, meaning he would pay the first $1,000 out of his own pocket before coverage kicks in.
He worries about suffering injuries in a car accident or falling ill before he’s eligible for Medicare at age 65.
“I don’t like feeling vulnerable like this,” Nishimura said. “I’m completely vulnerable to some catastrophic problem.”
Nationally, about 50,000 people with pre-existing conditions have signed up for the coverage available through the health care law, fewer than expected. The government has offered new options to encourage more to enroll. In another two years, he may be eligible for subsidies under the law for insurance.
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Name: Samantha Ames
Home: Washington, D.C.
Age: 25
Occupation: Law student
Insurance coverage: Got back on parents’ insurance, thanks to the health care law.
As a teenager, Ames was prone to ankle injuries playing catcher on baseball and softball teams. Last April, she tripped over her mini bulldog and badly injured her left ankle. Ultimately she needed surgery that cost her insurer $30,000.
But she considers herself lucky.
Only a few months before her accident, Ames had been able to get back on her parents’ insurance, thanks to a provision of the health care law that lets young adults keep that coverage until they turn 26. Nationally an estimated 2.5 million young people have gotten insurance as a result.
Ames says it’s unclear if the student health insurance she had been relying on previously would have covered her surgery. In any case, the copayments would have been steep. She would have had to postpone the operation, risking another — potentially crippling — injury.
“The fact that I was able to get on their plan is the reason I can walk today,” said Ames. “Very rarely have I had something political affect me this personally.”
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Name: Sharon Whalen
Home: Springfield, Ill.
Age: 59
Occupation: Publisher of a weekly alternative newspaper
Insurance coverage: Small group plan.
As a co-owner of the Illinois Times, a weekly newspaper, Whalen wants to keep her small staff healthy. So she and her business partner provide them with health insurance and pay half the cost of premiums for their 10 employees.
Keeping that employee benefit is getting more and more expensive. The company saw a spike in premium costs after one employee’s child had chronic health problems.
With costs climbing, the company switched to a managed care plan with higher copays for some services in 2009. Whalen’s company also contributes less than it once did to cover the premiums of employees’ family members.
The health care law brought some relief: a tax credit for small businesses that provide health coverage. The Illinois Times qualified and received a $2,700 tax credit last year.
“We see ourselves putting that money right back into the company,” Whalen said.
Whalen heard about the tax credit from a health care advocacy group, not from her accountant.
“I had to practically beg them to look at this,” Whalen said. “They weren’t familiar with it.”
The Obama administration has proposed expanding the number of businesses eligible for the credit, and simplifying the paperwork.
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Name: Melissa Pearson
Home: Prineville, Ore.
Age: 53
Occupation: Retail sales, part time.
Insurance coverage: High-deductible plan purchased on individual market.
A few years ago, Pearson’s doctor ordered her to have a routine colonoscopy. It’s one of several colon cancer screening methods highly recommended for adults ages 50 to 75.
Pearson kept putting it off, in part because of the cost. Her high-deductible health insurance plan requires her to pay the first $5,600 out of her pocket each year. She knew the colonoscopy would be expensive and figured she’d be paying.
Then she learned that a provision in the health care law requires health plans to cover all costs for preventive care including colon cancer screening — with no out-of-pocket costs to the patient.
“That’s what made me make the appointment,” she said. She also scheduled a mammogram and cervical cancer screening, which also are covered preventive services under the law. In all, she saved nearly $3,000 in out-of-pocket costs last year because of the Affordable Care Act.
“I said to my sister, ‘Thank you Obamacare,” Pearson said.
The Obama administration says the Affordable Care Act provided about 54 million Americans with at least one new free preventive service last year through their private health insurance plans.
But Pearson is worried that covering preventive services will mean her insurance premiums and her taxes will go up. “It’s being paid for by somebody,” she reasoned. She recently talked with a student from Norway who told her about the tax levels in that country. “I’m fearful our world will turn into that.”
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Name: David Zoltan
Home: Chicago
Age: 34
Occupation: Field marketing coordinator for a public relations firm.
Insurance coverage: Federally funded health plan for people with pre-existing conditions.
Zoltan lost a job and his health insurance during the recession. His diabetes sent him to the emergency room three times when he ran out of insulin during the two years he was uninsured.
In 2010, he was one of the first to sign up in Illinois for a new health insurance program for people with pre-existing conditions. The Affordable Care Act set aside $196 million for the state of Illinois to start the program.
Zoltan now pays about $1,848 a year for that coverage. The plan has a $2,000 deductible, meaning Zoltan also pays that amount out of pocket before the coverage starts.
Zoltan has found work, but his new job doesn’t include health benefits, so he’ll stay on the federally funded health plan.
“As a diabetic, I never again want to be without health insurance,” Zoltan said. “Anything is better than not having coverage at all.”
He is watching the Supreme Court as it considers the law. The requirement that Americans buy health insurance is under constitutional scrutiny. Zoltan believes the individual mandate is needed to spread the risk among the well and the sick, and keep insurance affordable.
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Name: Carol McKenna
Home: Pembroke Pines, Fla.
Age: 70
Occupation: Retired.
Insurance coverage: Medicare Advantage plan.
McKenna and her husband Morty have noticed that Medicare’s “doughnut hole” is shrinking. The coverage gap in Medicare’s prescription drug program — dubbed the “doughnut hole” — caught Morty in December last year. But once there, he received a 50 percent discount on brand-name drugs and other discounts on generic drugs thanks to Obama’s health care law.
Last year, he received a $250 rebate check provided by the new law for people in the doughnut hole. Under the health care law, the gap will be gradually phased out by 2020.
Warnings about possible cuts to Medicare Advantage plans caused by the health care law haven’t come true, Carol McKenna said. Their health plan still includes extra benefits such as fitness center membership.
She said she’s grown weary of the political debate over the health care law.
“I’ve been following it somewhat. Then it got so convoluted and out of control during the elections that I stopped paying attention,” McKenna said. “I don’t want to hear it anymore. All they’re doing is sniping at each other.”
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Alonso-Zaldivar reported from Washington.
The bottom line on health insurance is becoming clearer every day. Increasingly, we are dividing ourselves into two separate classes as defined by insurance coverage. The lower income world is one in which most jobs do not include coverage of health insurance. These workers often work full time but have no coverage made available to them. As soon as they get sick or hurt, they are in jeopardy of losing everything they have and will have for the rest of their lives.
On the other end of the spectrum you have the higher paying jobs where coverage is provided.
You couldn’t find a more definitive way to divide the classes if you tried. Laborers are increasingly hired as contractors to evade insurance liability. These workers do fine until they require expensive care, then they are bankrupt.
Health insurance is really bankruptcy insurance. This has become a weapon of the rich upon the poor. For them, if they get sick, they do not worry about financial ruin.
Without the affordable care act, this disparity will continue to grow as will the premiums of the insured. This poses no problem to the insurance company elite. They make out no matter what.
IF you support candidates who are against this law, you should be asking what their solution is. Doing nothing will continue to drag our economy down and make America less attractive as a place to manufacture goods, a place to live and a place to invest. Until we tackle this problem, increasing federal deficits and increasing budgetary strife for state governments will continue, unabated. Do nothing is not an option, we cannot afford it. This option ends up more expensive than the ACA and fewer people end up with having their basic needs met.
While I agree we definitely need health care reform I don’t see this as being the proper solution. Having the government involved is not the best way to manage health care, just look what they do to everything else. One problem I do see however is that we have no candidates with viable solutions which is a point you touched on at the end. I’m disappointed in the fact that it’s a vote for one person who supports the new law or vote for this person who doesn’t. Why isn’t there someone stepping up with a different solution?
I’m a firm believer that insurance companies have for too long been in control of not only their own profits but the profits of Dr.s, employers, and employees. However, I give our government blame for that as well. For years they haven’t allowed us to buy insurance across state lines which would bring competition to every state. They allow monopolies which is definitely un-American if you ask me. I can only guess at the reasons for this and would assume there have been some pockets lined in the process. I don’t like the new law, I believe it’s unconstitutional on many levels but I do believe that if one were to read through all the fine print (unlike most of those that voted on it) I think there’s most likely some very good ideas in it as well. This whole debacle shows the greatest need for new blood and new ideas in Washington. It also proves that we need term limits and to bring congress back to our level, making them follow the same rules as everyone else as they’re supposed to. Perhaps by changing the people in the chairs in Washington a fresh debate can begin and real solutions can come about that all of us can get behind.
How is the government involved? It sounds like you are listening to the BS that gets spread on talk radio, not looking at the facts.
If you think putting another republican in the White House will do anything but bust the economy again, you deserve the mess. A fool and their money ….
New blood is funny. Do you really think the president changes the dynamics? You are a worthless pawn to the powers that be in DC. You are now and always will be to them. They have no intention on making life better for anyone except the most well heeled.
So naive.
Huh, interesting. I open up a dialogue that doesn’t attack you in anyway and you come out throwing punches. That’s fine. But I never mentioned anything about the president (and yes president is lowercase because for the record I can’t stand the man or what he stands for) I don’t really care for ANY of the people who’ve been elected in the house of reps or the senate in you want the truth of the matter. I don’t listen to talk radio but read and research my news, but it sure seems like you need to step away from whatever it is you’re reading/listening to and take a look at both side because your bias is showing. I, in-fact, don’t care for any of the R Presidential candidates anymore than I care for the current man sitting there. I think they’re all of the same mold. Control, control, control.
So now that you have your facts straights I’ll get to my original point. That fact that you can’t see the government involvement in Obama care either means you don’t know how to read or your just ignorant to the actual facts of this whole deal. Since you can write and responded to my post I’m going to make the assumption you can read so that’s argument is dead. The best example as to how the govt is going to be involved is forcing people to either buy insurance or pay a penalty….WHAT? THIS IS AMERICA, I have the right to pick and choose what I do with my money. If others didn’t feel the same the issue wouldn’t be coming in front of the Supreme Court. I don’t want the govt involved what I purchase with my money any more than I want them involved in whether or not I look at porn (Santorum should just pull his lip over his head and swallow btw). To me the basic premis of any decision comes down to freedom. I don’t like that Obama wants to take away my purchasing freedom, I don’t like that Santorum wants to take away my right to look at porn, and I don’t like the fact the whole republican party wants to keep gays away from their freedom to marry. Call me naive if you like sir or madam, but I happen to think I’m pretty da** intelligent.
“I have the right to pick and choose what I do with my money.” So, er, if you own a car you don’t have to buy insurance for it in order to register it?
While I do own a vehicle, I don’t have too. If I don’t have a car I don’t have to have automobile insurance. Those are both CHOICES that I make. I like to have the freedom to pick and choose what’s right for me. Like I said in the first post, something needs to be done about the health insurance industry, cost of prescriptions, cost of care, ect. Violating the constitution isn’t it.
Very good comments. I’d just like to add to your argument that health insurance is for ‘you’, while compulsory auto insurance is to protect ‘the other guy’. The two can’t be compared.
I ran a health care non-profit in recent years. I can read. I understand the medical side and the business side here.
What you think Obamacare is, it is not.
You don’t get to pick and choose everything, my friend. You have to buy insurance to drive. You have to pay taxes for things you don’t agree with.
Right now you are forced to pay for indigent care through higher premiums and higher billing from the hospital. Placing the responsibility on every person who will need care at some point is more rational than the system we have now. Everybody needs a doctor at some point. You seem to think you have choices you really don’t have.
Have you stopped to ask yourself why the Heritage Foundation drafted what became Obamacare? The reason is that it is a non-government solution where people are responsible for buying their own coverage. this used to define conservatives. Now conservative is defined as rejecting anything this president proposes.
Freedom as you define it does not exist except in your own private utopia. Go there! The rest of us have to find ways to get treatment when it is required.
I love how you keep trying to point out any argument I make as somehow coming directly from the mouth of conservatives. I’m not a conservative, I’m a libertarian actually. I still believe in the rights that founded this country. I don’t care what side came up with this bill, I don’t like it and don’t believe it’s constitutional. There are solutions to be had but rather than pursue those this president would rather make the people of this country more indebted to him, then again so would most of the people running for president I believe. Perhaps freedom as I define it doesn’t exist except in my own private utopia. But it’s a utopia I share with many others believe it or not. Believing in freedom for all is what I was taught this country was founded on and it’s what I believe. The rights that men have fought and died for. You and your ilk can continue to give away those rights all you want but I refuse.
Did you forget Dems lost big time in the 2010 elections? It was a sign that it took people all of two years to become fed up with what they were seeing from the dems. The R’s did a poor job picking candidates and now were in this mess. Whom ever is elected for any office this years is most likely going to be chosen because people see them as the best of the worst. It’s a sad state of affairs really. I’ll let you continue to perpetuate the ignorance and willingness to give away rights for a few dollars here and there.
So you are fighting against the law that will bring more competition to places like Maine….. You don’t like monopolies? How many choices do you get when selecting health care in Maine right now?
You have allowed yourself to be snowed by the corporate sponsored message that mischaracterizes this law and issue.
I’m a big second amendment advocate. If they were proposing a bill that would advance that agenda but had other things in it that went against the constitution I’d be against that too. What you don’t seem to understand is that I’m not against competition for coverage and bringing costs down, I’m against the way they’re going about it. Don’t give me this corporate sponsored message garbage either. The argument you’re making could have come right off some liberal talk radio or tv station. You’re presenting absolutely nothing original. Instead of spouting off like the rest of the sheep in both parties present something original. Perhaps then something tangible will be achieved rather than the same bs that’s put this country where it is today.
I am not spouting recycled BS, I managed a health care business in Maine for the last few years. I am giving you first hand rebuttal.
I am telling it to you like it is, Obamacare is not government controlled health care. There is nothing about the care side in the law. It is only about accessibility of insurance.
It is a travesty that working people are deprived of coverage. Nothing is more essential to all people than access to medical care.
You argue for continuing the system that is so inefficient and benefits so few. Competition will not come naturally. This industry does not operate under normal supply and demand principles.
The mandate is a conservative approach. Personally, I think we should go for the single payer system. Why we must have a profit motive for every piece of American life I do not understand.
*sigh…either I did a really terrible job getting my point across or you just missed what it was I was attempting to say from the start. I AGREE that something needs to be done! What we have now is not the solution. I haven’t had health insurance for 4 years so I understand the plight of people. I’m still paying bills from a hospital visit almost two years ago. Believe me, I get that there’s a problem. No where did I ever argue for the current system. How can I in good conscience as it’s obviously broken. What I said is Obama care is not the answer. How can we force people to either pay for insurance or fine them if they don’t? That’s whats at the heart of the matter in the Supreme Court case. That I do not believe in. And when you read the law over, the government has way too much involvement, it’s as simple as that. Do we need to regulate the insurance industry? Absolutely. Limit the amount of malpractice suits that are driving up insurance for Dr.s, yes I believe we do. Opening up the borders to purchase insurance and bring out more competition.
That would be a great start. The medical industry in this country is a joke. When a Dr is getting vacations from a big pharma company I would call that a conflict of interest. Apparently in the industry it’s just called business. People also need to start taking their health into their own hands. We’ve become fat, lazy, and addicted to the quick fix. We eat out too often, don’t eat enough quality food, get limited exercise, watch too much tv, and shovel pills into out mouths to take away symptoms rather than doing things to actually solve the issue. It’s a sad state of affairs and the cost of health care would come down if people weren’t so reliant on it to fix problems they’re causing themselves. As far as I’m concerned people are doing as much damage to the cost of health care by not helping themselves as smokers do by sucking down cancer sticks. You’re in the medical field, I could be wrong but I have to believe you see things like this on a daily basis. As to why we have to make a profit, I’ll just leave that argument alone. I can definitely see a disagreement coming about in that conversation and while I like to have a debate with people, it’s not one that I see solving anything.